Epidemiology of stroke

Epidemiology

Despite the fact that stroke is largely preventable, the global incidence of stroke is rising, there is still relatively low awareness of the risk factors1, and until recently, stroke has not been seen as a top healthcare priority.2,3 There is now increasing pressure on health authorities to focus more on non-communicable diseases, especially heart disease, stroke and diabetes, and introduce more effective measures to prevent stroke and optimise stroke care in line with international guidelines.4

Burden of stroke

Stroke is the second leading cause of death worldwide, exceeded only by ischaemic heart disease.5

United States

In the US, each year approximately 795,000 people experience a new or recurrent stroke.5 In 2015, on average every 3 minutes 45 seconds a person died of stroke, accounting for ~ 1 in 19 deaths in the United States.5 From 2011 to 2014 the overall stroke prevalence was estimated at 2.7%.6

Europe

In Europe, stroke is the second leading cause of death responsible for 405,000 deaths in men and 583,000 deaths in women each year.6 Stroke accounts for nearly 14% of all new CVD cases in Europe with approximately 1.6 million new stroke cases in total.6 With 880,000 vs. 680,000 new cases the incidence is slightly higher in females than in males.6

China

In China, the incidence for all stroke types is 601.9 per 100,000 (age-adjusted).7 The prevalence ranges from 1.6% in rural areas to 9.3% in urban areas.8 In terms of mortality, stroke is responsible for 28.8% (urban) to 29.1% (rural) of all death in total - one of the highest rates worldwide.9

Geographical differences: Low-income vs. high-income countries

There are substantial geographical differences in the burden of stroke, with low- and middle-income countries bearing the highest burden of stroke.

In 2013, the number of deaths from stroke was 4.85 million in low- and middle-income countries compared to 1.6 million in high-income countries.10

Likewise, the number of DALYs in developing countries was 91.4 million versus 21.5 million in high-income countries.10

Gender differences

A higher global incidence of ischaemic but not haemorrhagic stroke is reported in men than in women. The incidence rate in women has significantly decreased between 1990 and 2013, but in men the decrease was not significant.11

The number of DALYs lost to stroke is similar in men and in women, although the DALYs lost have increased in both sexes from 1990-2013.11

The financial burden of stroke

Total estimated costs of stroke in the United States is 40.1 billion USD, with 23.6 billion USD in direct medical costs.5